7/30/2019 Introduction of Calculi

1/25

SEMINAR ON ANALYSIS

OF CALCULI

PRESENTED BY

ANU PRASHER

B.Sc. MLT FINAL YEAR

MODERATOR

DR. HARJEET KAUR

7/30/2019 Introduction of Calculi

2/25

INTRODUCTION

An abnormal solid conc. of mineral and Salt formedaround organic material

Found in cysts and ducts

Found in bladder, renal pelvis, kidneys & ureter

Largest stones are found in bladder

7/30/2019 Introduction of Calculi

3/25

Small stones are found in renal pelvis, Kidney and ureter

Can be of varying sizes

Requires nucleus on which crystals are deposited.

Its presence can obstruct urinary flow and can cause

infection and haematuria.

7/30/2019 Introduction of Calculi

4/25

Uric acid stones

Calcium oxalate stones

Phosphate stones

Calcium carbonatestones

TYPES OF STONES

Cystine Stones

Xanthene Stones Fibrin Calculi

Urostealith

7/30/2019 Introduction of Calculi

5/25

Uric Acid stones are round or oval

Uric Acid Stones are almost coloured varying shadesof brown

They may be single or multiple

Usually found in patients with gout but also found in

patients with bladder outflow obstruction.

They are usually fairly hard & often have a smoothsurface though sometimes they may be rather tough

URIC ACID STONES

7/30/2019 Introduction of Calculi

6/25

CALCIUM OXALATE STONES

They are found in a majority of calculi usually mixed with agreater or less amount of phosphate

Oxalate Stones are among the hardest stones found and Soare not easily crushed

The surface of small oxalate stones is often rough andblood stained

Oxalate stones is a primary stones that grows slowly,usually it is of moderate size and is solitary

Sometimes it bristles with spines

7/30/2019 Introduction of Calculi

7/25

PHOSPHATE CALCULI

It may contain either triple phosphate or calciumphosphate

Calcium phosphate , mixed with calcium oxalate is a common

finding in patients with hypercalciuria

Triple Phosphate is deposited when the urine is alkalineand so is usually found when there is infection of urinary

tract, when urea is converted into ammonium carbonate

These are among the softest & whitest stones

7/30/2019 Introduction of Calculi

8/25

CALCIUM CARBONATE STONES

Calculi consisting mainly of calcium carbonate are very rarein man but small amounts of the substance can be detected in

the number of calculi

Stones containing carbonate tend to be rather hard

The salt is deposited as carbonate-apatite from alkaline,infected,carbonate rich urines

7/30/2019 Introduction of Calculi

9/25

CYSTINE STONES

These are also rare

They are usually fairly small and are smooth and waxy inappearance and to the touch.

They are brownish Yellow or Light green in colour and occur

in cases of cystinuria.

The increased cystine excretion is often the cause ofcalculus formation as in case of cystinuria

7/30/2019 Introduction of Calculi

10/25

XANTHINE STONES

They are even rarer than Cystine

They are Yellowish brown in colour being rather similar touric acid calculi

They sometimes contains uric acid

They occour in case of xanthinuria

7/30/2019 Introduction of Calculi

11/25

UROSTEALITH

Urostealith calculi have been reported in bladder

They are soft and contain a large amount of fat

They are extremely rare

7/30/2019 Introduction of Calculi

12/25

FIBRIN CALCULI

Fibrin Calculi may form from blood clots

They are rare but may form the nucleus of other stones

7/30/2019 Introduction of Calculi

13/25

Factors causing the formation of Stones

Certain conditions are recognized as being favourable forstone formation but do not explain the presence of somestones

It is known that stagnation of urine particularly if there isalso infection present may lead to stone formation

e.g. in

Hydronephrosis

Enlarged prostate

Bladder Infection Hyperparathyrodism

Hypervitaminosis D with excessive mobilization anddeposition of calcium are also known to be

accompained by formation of calculi

7/30/2019 Introduction of Calculi

14/25

URINARY CALCULI

These may be found in any part of urinary tract like kidney,renal pelvis, ureter.

They vary very considerably in size from little more than pinhead to the size of an egg

The passage of stones down the ureter produces renal colic,which is characterized by serve pain in the back radiating tothe groin region

Stones may also be passed through the urethera with greatpain

Hematuria is a common urinary finding when symptoms ofstone are present.

7/30/2019 Introduction of Calculi

15/25

KIDNEY STONES

7/30/2019 Introduction of Calculi

16/25

GALL STONES

Substances found in Gall stones are

Cholestrol Bile Pigments

Calcium Phosphate and

Calcium Carbonate

Cholestrol stones are often white or light coloured,mixed stones are usually quiet dark

They may be single multiple,large or small.Thosecontaning Ca salts are radio opaque

Their presence ,however ,predisposes to attacks ofcholecystitis with formation of debris and impairedemptying of the gall bladder

7/30/2019 Introduction of Calculi

17/25

GALL BLADDER STONES

7/30/2019 Introduction of Calculi

18/25

7/30/2019 Introduction of Calculi

19/25

PANCREATIC CALCULI

7/30/2019 Introduction of Calculi

20/25

Salivary Calculi are occasionally submitted forexamination

They are most commonly composed of calciumphosphate and calcium carbonate with small amountof organic matter

They are usually formed in the parotid orsubmandibular ducts

SALIVARY CALCULI

7/30/2019 Introduction of Calculi

21/25

SALIVARY CALCULI

7/30/2019 Introduction of Calculi

22/25

Enteroliths :-

It consist mainly of phosphates deposited around anucleus which is often a foreign body such as fruit stone

Some organic material or faecal pigment are present

Small enteroliths may also be formed by the

deposition of phosphate on undigested vegetablematerial

FAECAL CONCRETIONS

7/30/2019 Introduction of Calculi

23/25

Coproliths :-

Are almost entirely organic containing hardenedfaecal material formed from stationary faecalmatter in colon

Drug calculi :-Small stones may be formed from drugs which are insoluble or

only slightly solublee.g.

Magnesia

Barium Sulphate

7/30/2019 Introduction of Calculi

24/25

MONITORING PATIENTS

For the common calcium stones, large amounts of fluids andtheazide diuretics are used for treatment

Thiazides plus and allopurinol are used for patients with

calcium stones who have increased calcium and uric acid inurine

Stones resulting from infection contain bacteria and are

removed surgically and the appropriate fluids and antibioticstherapy instituted

7/30/2019 Introduction of Calculi

25/25

THANK YOU